The River Source Treatment Center Casa Grande, LLC

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

Legal business name

THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC

Practice address

2325 W Guadalupe Rd BLDG 2 Ste 107
Gilbert, AZ 85233-2811

Phone

(866) 367-8069

Fax

(520) 413-5944

NPI assigned

Jan 2, 2023

Last updated

Oct 7, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christina Valencia

Title

Finance Director

Phone

(480) 298-7301

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

The River Source Treatment Center Casa Grande LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• The River Source Treatment Center Casa Grande, LLC

  • Substance Abuse Rehabilitation Facility
  • Arizona City, AZ
  • NPI 1003053570
  NPD tax ID
• The River Source Treatment Center Casa Grande, LLC

  • Addiction Psychiatry Physician
  • Phoenix, AZ
  • NPI 1447946330
  NPD tax ID
• The River Source Treatment Center Casa Grande, LLC

  dba The River Source Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Arizona City, AZ
  • NPI 1487367314
  NPD tax ID
• The River Source Treatment Center Casa Grande, LLC

  • Addiction (Substance Use Disorder) Psychologist
  • Arizona City, AZ
  • NPI 1568243103
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Natalie Summit, LPC

  • Professional Counselor
  • Gilbert, AZ
  • NPI 1548826258
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1851004220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4293",
            "city": "ARIZONA CITY",
            "state": "AZ",
            "postal_code": "851232669",
            "telephone_number": "480-298-7301",
            "fax_number": "520-413-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 W GUADALUPE RD BLDG 2 STE 107",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852332811",
            "telephone_number": "866-367-8069",
            "fax_number": "520-413-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RIVER SOURCE TREATMENT CENTER CASA GRANDE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-02",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "VALENCIA",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "480-298-7301"
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "544985",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "theriversource.org",
            "affiliation": "N",
            "address_1": "2325 W Guadalupe Rd Ste B",
            "city": "Gilbert",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852332811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Children's Substance Abuse Rehabilitation Facility in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Children's Substance Abuse Rehabilitation Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.